hi, v have recently implemented EHRsystem at our hospital but i m having a problem that doctors are not putting their note properly as they do in papper. what coulb be the remedy because its easy for them to write on papper rather than in sytem at patient bed side.

Dear all I totally agree whatever you guys described about EHR software usage but as a Doctor and I have my own clinic I must share my thoughts with you.

I was not using EHR software in begging but as I feel me and my staff were investing our time on reports, prescriptions, patient details and blah blah .... One day one of my best friend Dr. Gupta suggested me to buy an EHR / EMR software, I start my searching on internet and I found an EHR system provider NORTEC SOFTWARE INC www.nortecehr.com, I contacted with them and I purchased a complete Electronic health record suit for my clinic.

Since that day I analyzed few things positive like .. I don't need to use my maximum staff, All records now on my finger tips, My patients are also happy with our services, Very user-friendly and most importantly I am saving a big part of my earning means better ROI.

At the end I must say there are a lot of advantages in EHR software utilizations.

From what I see, many issues come from the lack of communication between EMR vendors, labs, and medical devices. It'd be great if all the information was stored in the EMR but many times it's not and so patients information requires multiple clicks and signons to find out what is needed and requires manual input. It doesn't help that EMR vendors can charge an obscene amount to create connections to their solution to send/receive information to/from outside sources.

Mirth Connect seems to help save costs in many of these areas (I am a sales person for Mirth but Mirth Connect is available as a free open source solution).

I recently saw a chart on HealthIT.gov that demonstrated the more in-depth a clinic or hospital delves into an EHR system, the more satisfaction seems to go up. I wonder if maybe the high dissatisfaction that's being reported in blogs all over the internet are caused by lack of training or lack of full implementation?

The root cause of this problem is the business model of healthcare, and its protection from competition on cost and quality (unlike other industries). Until this is fixed, EHRs will be viewed as a cost center, and not as a strategic weapon to improve cost and quality.

For example, even in settings where EHRs work well and have high usability, doctors still click through Rx interaction warnings and ignore them because they take too much time to deal with. Why would they do this? Because they are not paid for quality of outcome, nor are they incentivized to minimize the net present value of the 'cost stream' of a given patient to the system.

So until these underlying incentives are changed at a systemic level, the never ending tug-of-war will continue between docs and IT in a largely zero-sum game. No other industry with real competition on cost and quality would take 20 years and find that only 5% of it's employees consistently use software (productively) at the point-of-service.

Tough to disagree with the participant comments. HealthCare IT serves two masters with widely differing agendas - administrators and caregivers. The administrative burden is to provide summary reports and billing coding for insurance and mandated government reporting. Caregivers need easy data input and timely and relevant synopsis and correlation of critical information based on inputs from various sources - for example, conflicting prescriptions from specialists treating the same patient but who are not familiar with what other regimens the patient may be under from other Doctors and caregivers. The point of the EHR was to have a single source of truth provide a global view of what is happening to a patient. Instead we have multiple systems that cannot communicate with one another - creating silos of information. This is what I am hoping the Affordable Health Care act addresses - but it will take time. WIth the Political element trying to destroy better healthcare for Americans it will take even more time. Currently we have "Health Care Systems" built from older IT building blocks and re-purposed for health. They then had to expand to include the regulatory environment, billing environment and somehow lost the plan to build an "ideal" practice UI for doctors and nurses. We need to get back to that and then use IT in the background to mate the caregiver interface with the backend billing and abstract the administrative overhead out of the way of the practice pieces. Ultimately a cloud based system based on universal rules and best practices is where we need to head. Don't see the need personally for coding methodologies and caregiver training to track my flu-shot to differ between Oregon and Alabama.

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